New treatments successfully halt skin cancer spread and recurrence

A team of Australian researchers has successfully trialed a combination of new treatments to stop melanoma in its tracks and to prevent it from metastasizing to other organs in the body.

Ground-breaking results from two international clinical trials done by investigators at the Melanoma Institute Australia have been presented on Monday at the European Society for Medical Oncology (ESMO) 2017 Congress in Spain. The study has also been published in the New England Journal of Medicine.

The two trials, COMBI-AD and CheckMate 238 successfully prevented the spread of the disease in Stage 3 melanoma patients whose tumours had been surgically removed. Until now, these patients were at high-risk (40 to 70 percent) of their disease progressing to advanced and fatal melanoma.

“These results will change the way we treat melanoma patients as well as their quality of life,” said study author Professor Georgina Long, Conjoint Medical Director of Melanoma Institute Australia and Chair of Melanoma Medical Oncology and Translational Research at The University of Sydney.

“Until now, Stage 3 melanoma patients who have had their tumours surgically removed have simply had to play the waiting game, to see if their melanoma would metastasise or spread. Living with such fear severely affected them and their loved ones.

“Results from these clinical trials suggest we can stop the disease in its tracks – effectively preventing it from spreading and saving lives. Our ultimate goal of making melanoma a chronic rather than a terminal illness is now so much closer to being achieved,” she said.

The Checkmate 238 trial involved patients with high-risk Stage 3 and Stage 4 disease who had had all melanoma removed surgically. The patients were randomized to be treated with immunotherapy nivolumab or ipilimumab for 12 months. Immunotherapies reboot the immune system to attack the melanoma cells. Results of the trial showed nivolumab decreased the chance of relapse. It also had a superior safety profile over ipilimumab.

In the other trial, COMBI-AD, patients were randomised to receive a combination of targeted therapies (dabrafenib and trametinib) or placebo for 12 months. Targeted therapies block the action of a gene which is a driver for melanoma. The therapy not only prevented resected Stage 3 melanoma from recurring but also increased overall survival.

The clinical trials are the first in the world to provide treatments to melanoma patients at an earlier stage of the disease to prevent spread and recurrence.

“These clinical trials show we now have ammunition to prevent melanoma spreading and progressing, which until now was a critical area of disease behaviour where we had no control,” said Professor Long.

“This will change how melanoma is treated around the world, as we no longer have to passively wait to see if the melanoma spreads.

“We can now actively and effectively attack the melanoma at an earlier stage, reducing the dreadful anxiety for patients about progressing to a potentially terminal illness and ensuring they have much better outcomes.”

Melanoma is one of the deadliest forms of skin cancer, with one Australian dying from advanced melanoma every five hours.

In 2016, the Australian Institute of Health and Welfare released a report showing an increase in the number of Australians being diagnosed with skin cancer.

Cancer Council Australia estimates that the country spends over $ 1 billion per year treating skin cancer, with costs increasing substantially over the past few years. Two years ago, the Council released a study showing that more than 2.5 million Australians spend half or more of their working time outdoors, yet only half of them reported having a sun protection policy in place.

The Cancer Council said about 34,000 skin cancers and 200 melanomas are caused by sun exposure in Australian workplaces every year.